Declining diagnostic accuracy of non-invasive fibrosis tests is associated with elevated alanine aminotransferase in chronic hepatitis B

Table 2 Fibrosis scores of the non-invasive tests for liver fibrosis stages in the different alanine aminotransferase groups

Characteristics	APRI	FIB-4	GPR	King’s score	Forns index
S0 (n)
ALT ≤ 40 (128) 40 < ALT ≤ 80 (80) ALT > 80 (56) P-value	0.37 (0.26-0.44) 0.51 (0.39-0.68) 1.02 (0.85-1.5) < 0.001	0.88 (0.65-1.26) 0.77 (0.57-1.15) 0.97 (0.74-1.52) 0.019	0.15 (0.1-0.2) 0.22 (0.14-0.31) 0.29 (0.22-0.48) < 0.001	4.3 (3.09-5.89) 5.91 (4.1-8.08) 11.62 (7.99-18.36) < 0.001	6.06 (5.04-7.03) 6.16 (4.91-7.04) 6.27 (5.36-7.26) 0.5
S1 (n)
ALT ≤ 40 (73) 40 < ALT ≤ 80 (53) ALT > 80 (21) P-value	0.36 (0.3-0.44) 0.52 (0.42-0.72) 0.94 (0.65-1.68) < 0.001	0.92 (0.7-1.29) 0.82 (0.58-1.28) 1.1 (0.85-1.36) 0.177	0.13 (0.1-0.19) 0.23 (0.19-0.32) 0.55 (0.23-0.89) < 0.001	4.59 (3.54-6.42) 6.55 (4.11-9.67) 11.7 (8.58-21.25) < 0.001	5.9 (5.24-6.99) 6.04 (5.34-7.32) 6.95 (6.06-7.54) 0.098
S2 (n)
ALT ≤ 40 (35) 40 < ALT ≤ 80 (29) ALT > 80 (32) P-value	0.44 (0.37-0.58) 0.76 (0.66-0.93) 1.32 (0.87-2.15) < 0.001	1.2 (0.8-1.54) 1.34 (0.98-1.83) 1.24 (0.82-1.73) 0.472	0.2 (0.12-0.34) 0.32 (0.21-0.54) 0.45 (0.25-1.09) < 0.001	5.88 (4.26-9.25) 10.9 (7.6-13.85) 12.42 (9.95-28.94) < 0.001	6.79 (5.97-8.06) 7.55 (6.41-8.1) 6.5 (5.41-7.67) 0.111
S3 (n)
ALT ≤ 40 (19) 40 < ALT ≤ 80 (18) ALT > 80 (17) P-value	0.49 (0.38-0.74) 0.81 (0.73-0.98) 1.95 (1.35-5.32) < 0.001	1.2 (0.9-1.62) 1.57 (1.18-2.11) 2.23 (1.47-2.81) 0.023	0.34 (0.17-0.44) 0.46 (0.22-0.57) 0.89 (0.46-1.57) 0.001	7.28 (4.44-9.28) 11.8 (9.59-16.76) 28.37 (18.46-48.99) < 0.001	7.48 (6.4-8.01) 7.99 (7.01-8.79) 7.38 (6.32-9.15) 0.538
S4 (n)
ALT ≤ 40 (17) 40 < ALT ≤ 80 (10) ALT > 80 (11) P-value	0.57 (0.49-0.73) 0.67 (0.6-0.85) 1.95 (1.09-3.37) < 0.001	1.78 (1.24-2.49) 1.31 (1.09-1.45) 1.82 (0.92-3.3) 0.168	0.35 (0.18-0.58) 0.4 (0.29-0.5) 0.55 (0.46-0.94) 0.019	9.48 (6.15-14.1) 8.96 (8.26-11.96) 27.56 (12.86-45.31) 0.001	8.4 (6.35-9.3) 7.67 (6.71-8.15) 7.48 (5.77-9.11) 0.617

Data are expressed as the median (interquartile range, IQR); ALT: Alanine aminotransferase; S: Stage of fibrosis; GPR: Gamma-glutamyl transpeptidase (GGT)-to-platelet ratio; APRI: Aspartate aminotransferase (AST)-to-platelet (PLT) ratio index; FIB-4: Fibrosis index based on 4 factors.